random Flashcards
classify types of haematuria
Glomerular
- Often associated with proteinuria
- Urine dip stick to test
Collecting system
- microscopic
- Little/no proteinuria
- Symptoms = lion to groin pain, clots, vomiting, anuria
Focal lesion
- Often asymptomatic
- Back-pain
- palpable mass e.g. malignancy
describe the differing symptoms between nephrotic syndrome and nephritic
nephrotic
- oedema, weight gain
- frothy urine
- loss of albumin
- hyerlipidema, malnutrition, infection, thromboembolism
nephritic
- loss of RBC
- haematuria and proteinuria
- raised BP and JVP
- inflammation
- oliguria
define acute tubular necrosis
Persistent oliguria and renal failure after correction of pre-renal condition
state the major transporters in each aspect of the nephron
proximal tubule
- Na+/K+/ATPase
- glutamine = HCO3- & NH4+
TAL
- Na/2Cl/K
- ROMK
early distal
- Na/Cl
late distal/CD
- principal = ENaC & ROMK
- intercalated = H/ATPase & H/K/ATPase
name the transport channel blockers
Na/2Cl/K = furosemide
Na/Cl = thiazide
aldosterone = spirolactone
CA = acetazolamide
what determines the volume of the ECF and why?
renal Na+ handling
because the osmolality of the ECF is kept ~constant, the amount of Na+ in the body determines ECF volume. To maintain a constant ECF volume the amount of Na+ excreted needs to match the input, from diet.
Describe the tissue organisation of the ureter and bladder
- transitional epithelium - means that the ureter can expand in size when required and the epithelium can “flatten” to make more space (becomes stratified columnar to stratified squamous) –> stratified columnar –> stratified squamous
- mucous membrane for lubrication and protection of bacteria
- elastic lamina - allows stretch and recoil when lots of fluid is inside
- inner circular, outer longitudinal muscle
- adventitia (contains blood vessels and nerves)
Describe the tissue and cellular organisation of the different tubular segments of the nephron as a basis for understanding their function
PCT
- brush border = increase surface area
- pinocytosis = move large molecules
- lateral processes & infoldings
Thin descending
- simple squamous
- nuclei bulge into lumen
DCT
- no brush border or pinocytosis
- lateral processes & infoldings
- cuboidal cells
CD
- cuboidal to columnar
how is bone health affected in chronic kidney failure
there is a build-up of phosphate as it is not being excreted, this stimulates the PTH. Causing calcium to get leached out of the bones and increase the risk of fracture as a result of decreased calcium present within the bones.
what stimulates ADH release
- increase in osmolality sensed by osmoreceptors
- decrease in BP sensed by baroreceptos
describe the different prostatic zones
transitional zone
- BHP
- around urethra
peripheral
- where most carcinomas occur
- atrophy
treatment for tumours of the bladder
- superficial = BCG
- into detrusor muscle = cystectomy
define engagement
refers to how deep the presenting part is engaged in the bony pelvis
endometrial tumour types
non-neoplastic = endometriosis
pre-malignant = hyperplasia
benign = endometrial polyps
malignant = endometrial adenocarcinoma
fallopian tube tumour types
non-neoplastic = salphagitis
pre-malignant = tubular intraepitheial carcinoma
benign = adenotamoid tumour
malignant = carcinoma
myometrium tumour types
non-neoplastic = adenomyosis
benign = leiomyomas
malignant = leiomyosarcoma
cervix tumour types
non-neoplastic = cervitis
pre-malignant = squamous intraepithelial lesion (SIL)
benign = endocervical polyps
malignant = SqCC
describe the differences and origins of seminoma and non-seminoma GCT
seminoma = gonadal germ cell
NSGCT
- Embryonal carcinoma
- Teratoma (ectoderm, mesoderm, endoderm)
- Choriocarcinoma (trophoblast)
- Yolk sac tumour (extra-embryonic, endoderm)
describe the normal sexual response cycle for females
arousal = vagina lubricates, clitoris swells, nipples erect
plateau = vulva swells, vagina lengthens
orgasm = Muscular contractions of outer 1/3 of vagina, uterus and anal area. Pleasant sensation felt
resolution = Return to baseline or unaroused state
refractory period = time delay before plateau stage can be re-entered
describe the normal sexual response cycle for males
arousal = erect penis, testes draw into body, nipples erect
plateau = Deepening vasodilation of genitalia. Pre-ejaculatory fluid
orgasm = Muscular contractions involving penis and perineum. Contraction of prostate gland and seminal vesicles (ejaculation)
resolution = return to baseline or unaroused state
refractory period = Penile erection may obtain but orgasm cant reoccur. Period lengthens with age and fatigue
name the perineal musculature
ischiocavernosus
bulbospongiosus
describe the deep perineal pouch
deep pouch of perineal membrane, more muscles in females as the path of the urethra is shorter
describe the superficial perineal pouch
everything from the perineal membrane to the skin
- e.g. nerves, vessels, erectile tissue, perineal muscles, Bartholin glands in females
differences in female and male pouches
males
- ‘membranous urethra’
- bulbourethral glands
- dorsal nerve of penis
females
- vagina
- urethrovaginalis muscle
- dorsal nerve of clitoris
